Search

School refusal is a multicausal disorder with an estimated prevalence of about 5%. Patients are at risk for developing educational, social, and behavioral problems. Studies evaluating therapeutic interventions are, however, rare. Objectives: We prospectively investigated adolescents with prolonged school refusal who took part in a standardized group treatment program to find out if the program was suited for this group and if comorbid problems influenced the therapeutic progress. Patients and Methods: We investigated 18 adolescents admitted for prolonged school refusal. They were 10-14 years old and met ICD-10 criteria for social phobia (F40.1). All attended 16 sessions of manual-based, cognitive behavioral group therapy (CBT) [Joormann und Unnewehr, 2002] and were psychologically tested before, during and at the end of CBT. Results: 14 patients completed the study and the pre- and posttherapeutic assessment. Social phobia, clinical, and depression scores improved but not significantly. Temperamental factors ‘persistence’, ‘self-directedness’, and ‘cooperativeness’ were associated with better therapeutic success, ‘harm avoidance’ with higher social phobia scores and a less substantial clinical improvement. All patients had at least one comorbid axis-1 diagnosis, most frequently separation anxiety. Nearly all patients had impaired executive functions, and nearly all parents had psychiatric problems. Conclusions: The Joormann and Unnewehr CBT program was somewhat effective. Considering the high number of comorbidities, longer duration of treatment, additional treatment components and parental psychotherapy are recommended. [ABSTRACT FROM AUTHOR]

The magnetic behavior of the Jahn-Teller structure braunite, (Mn2+ 1−yM y)(Mn3+ 6− xMx)SiO12, is strongly influenced by the incorporation of elements substituting manganese. Magnetic properties of well-defined synthetic samples were investigated in dependence on the composition. The final results are presented in magnetic phase diagrams. To derive the necessary data, ac susceptibility and magnetization of braunites with the substitutional elements M = Mg, Fe, (Cu+Ti) and Cu were measured. Whereas the antiferromagnetic ordering temperature, T N, of pure braunite is hardly affected by the substitution of nonmagnetic Mg, it is rapidly suppressed by the substitution of magnetic atoms at the Mn positions. Typically for a concentration ( x, y) ≥ 0.7 of the substituted elements, a spin glass phase occurs in the magnetic phase diagrams. Additionally, for the braunite system with Fe3+ substitutions, we observe in the concentration range 0.2 < x< 0.7 a double transition from the paramagnetic state, first to the antiferromagnetic state, followed by a transition to a spin glass state at lower temperatures. The unusual change of the magnetic properties with magnetic substitution at the Mn positions is attributed to the peculiar antiferromagnetic structure of braunite, which has been resolved recently. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate longitudinal changes in set-shifting and central coherence in a predominantly adolescent cohort with anorexia nervosa (AN) and to explore whether these factors predict long-term eating disorder outcomes., Method: Ninety-two female patients with AN (mean age: 16.2, range: 13-21 years) completed neurocognitive tests (Rey Complex Figure Test, Adapted Version of the Wisconsin Card Sorting Test) before and after 12 months of psychotherapeutic treatment (n = 45 Maudsley AN Treatment, MANTRa; n = 47 standard psychotherapy; groups not randomised). Eating disorder severity was assessed at baseline, after 6, 12 and 18 months., Results: Central coherence (indicated by an increase in the Rey Figure Style Index) and set-shifting (indicated by a reduction in the percentage of perseverative errors) significantly improved over the course of treatment, with similar outcomes across groups. Lower central coherence was associated with higher eating disorder severity. Individuals with lower baseline set-shifting ability tended to have worse eating disorder outcomes in the long-term. However, this trend did not reach statistical significance in a multilevel linear mixed model., Conclusions: Neurocognitive difficulties in adolescents and young adults with AN can improve after treatment. Interventions specifically addressing flexibility in thinking and behaviour may contribute to treatment success., (© 2024 The Author(s). European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.)

Objectives: A rising incidence of eating disorders in the young population and limited effectiveness of available treatment approaches underscore the need for innovative therapies. This study explores therapists' perspectives regarding a promising new manualized psychotherapeutic treatment (MANTRa) for adolescents and young adults with anorexia nervosa (AN)., Methods: Semi-structured qualitative interviews were conducted with 10 therapists (nine female) who provided 24-34 sessions of MANTRa per patient. Interview topics included positive and negative experiences with MANTRa in general, with the workbook and other components. Reflexive thematic analysis was used to interpret the data. Furthermore, written notes taken by the therapists after each sessions were analysed., Results: The thematic analysis revealed five overarching themes: (1) Variety of therapeutic tools and content elements included in the workbook; (2) Getting the therapeutic process going; (3) Flexibility in use of the workbook; (4) Impact of the scientific and multidisciplinary framework on quality assurance; (5) Formal design of the workbook. Therapists' case formulation letters to the patients were regarded as powerful tools to strengthen therapeutic alliance and promote recovery. In-depth therapists' training, regular supervision and a multi-professional treatment setting were important factors to ensure high treatment quality., Conclusions: The findings suggest how the MANTRa content (e.g. inclusion of additional therapeutic tools), the therapists' training and the format (e.g. provision of a digital version) can be improved to reach maximum impact. Therapists' formulation letters may be an effective therapeutic tool not only for AN but also across the spectrum of psychiatric disorders in adolescents and young adults., (© 2024 The Author(s). Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Objectives: Young people's exposure to online pornographic material has increased in the past years. Its impact is a complex topic but an important issue due to growing concerns. Therefore, we reviewed the literature on Internet pornography consumption and its impact on children and adolescents. Furthermore, we examined young people's thoughts about pornography and their reasons for consumption., Method: We performed a systematic literature search in the online databases ERIC, PsycARTICLES, PsycINFO, and PSYNDEX for peer-reviewed articles in English, published between 2000 and 2022 and additionally identified secondary references., Results: We could determine associations between pornography consumption and demographic variables (e.g., age, gender), personal characteristics (e.g., [sexual] sensation seeking, sexual interest and experience, general risk behavior), environmental variables (e.g., peers, family), attitudes (e.g., gender role attitudes, permissive sexual attitudes), behavior (e.g. sexual risk behaviour, sexting) and sexual aggression (e.g., sexual cybervictimization, grooming). Moreover, we found that girls have a more negative attitude towards pornography than boys who have an ambivalent opinion on the subject. Most adolescents are aware that the majority of pornographic material is exaggerated and unrealistic. Furthermore, pornography is not only watched out of curiosity and for sexual arousal but also used as a source of sexual information, especially by minority groups., Discussion: Many effects that impair children's development have been documented. The results found in this review are often contradictory. Therefore, further replication studies are needed. In addition, we propose several preventive measures, e.g., sexual health education at schools for both heterosexuals and LGBT (Lesbian, Gay, Bisexual, and Transgender) people., (Copyright © 2024 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Objective: The aim of this study was examining the efficacy of the Maudsley Model of Anorexia Nervosa Treatment for Adolescents and Young Adults (MANTRa) compared to individual psychotherapy that can be considered as standard in Austria (TAU-O)., Method: In this cohort study, 92 patients between 13 and 21 years suffering from full-syndrome, atypical or weight-restored anorexia nervosa (AN) received either 24-34 individual MANTRa sessions (n = 45) or TAU-O (n = 47). Outcome variables were age- and sex-related BMI, eating disorder and comorbid psychopathology at 6-, 12- and 18-month post baseline as well as acceptability of treatment and therapeutic alliance., Results: Both treatments resulted in significant improvements in age- and sex related BMI and reductions in eating disorder and comorbid psychopathology over time with significant differences between groups in favour of MANTRa. The percentage of participants with fully remitted AN was significantly higher in the MANTRa group compared to TAU-O at 18-month follow-up (MANTRa: 46% vs. TAU-O: 16%, p = 0.006). Satisfaction with both treatments was high., Conclusions: MANTRa is an effective treatment programme for adolescents and young adults with AN. Randomised controlled trials comparing MANTRa with existing treatments are necessary., Trial Registration: The trial was registered at clinicaltrials.gov (Identifier: NCT03535714)., (© 2023 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.)

Background: Conspiracy beliefs have become widespread throughout the COVID-19 pandemic. Previous studies have shown that endorsing conspiracy beliefs leads to lower protective guideline adherence (i.e., wearing face masks), posing a threat to public health measures. The current study expands this research across the lifespan, i.e., in a sample of adolescents with mental health problems. Here, we investigated the association between conspiracy beliefs and guideline adherence while also exploring the predictors of conspiracy beliefs., Methods: N = 93 adolescent psychiatric outpatients (57% female, mean age: 15.8) were assessed using anonymous paper-pencil questionnaires. Endorsement of generic and COVID-19 conspiracy beliefs was assessed, in addition to items measuring adherence to protective guidelines and mental health (stress, depressive symptoms, emotional/behavioral problems, and adverse childhood experiences). Multiple regressions and supervised machine learning (conditional random forests) were used for analyses., Results: Fourteen percent of our sample fully endorsed at least one COVID-19 conspiracy theory, while protective guidelines adherence was relatively high (M = 4.92, on a scale from 1 to 7). The endorsement of COVID-19 conspiracy beliefs-but not of generic conspiracy beliefs-was associated with lower guideline adherence (β = - 0.32, 95% CI - 0.53 to - 0.11, p < .001). Conditional random forests suggested that adverse childhood experiences and peer and conduct problems were relevant predictors of both conspiracy belief categories., Conclusion: While a significant proportion of our sample of adolescents in psychiatric treatment endorsed conspiracy beliefs, the majority did not. Furthermore, and to some degree, contrary to public perception, we found that adolescents show relatively good adherence to public health measures-even while experiencing a high degree of mental distress. The predictive value of adverse childhood experiences and peer/conduct problems for conspiracy beliefs might be explained by compensatory mechanisms to ensure the safety, structure, and inclusion that conspiracies provide., (© 2023. The Author(s).)

Adsorption refrigeration systems and heat pumps still possess a relatively reduced market share as compared to the traditional compression systems. Despite having the great advantage of being powered by cheap heat (instead of expensive electric work), the implementation of systems based on adsorption principles remains limited to few specific applications. The main drawback that needs to be solved is their reduced specific power due to the low thermal conductivity and low stability of the adsorbents. The current state of the art of commercial adsorption cooling systems rely on adsorbers based on coated finned heat exchangers to optimize the cooling power. It is a well known result, that the reduction of the thickness of the coating derives in a reduction of the mass transport impedance, and that the increment of the ratio surface to volume of conductive structures increases the power without reducing the efficiency. The metallic fibres used in this work can offer a ratio of specific surface in the range of 2500-50,000 m 2 /m 3 .Three methods of preparing very thin but stable salt-hydrate coatings on metallic surfaces, including metallic fibres, for the production of coated heat exchangers with high specific power, are presented for the first time. A surface treatment based on aluminium anodizing was chosen to create a stronger bond between coat and substrate. The microscopic structure of the resulting surface was analysed by Scan Electron Microscopy. To verify the presence of the desired species Attenuated Total Reflectance-Fourier Transformed Infrared and Energy dispersive X-ray spectroscopy were employed in the analysis. Their capacity to form hydrates was verified via simultaneous Thermogravimetric Analysis (TGA)/Differential Thermogravimetry (DTG). Over a mass difference of 0.07 g(water)/g(composite) was detected in the coating of MgSO 4 , which showed signs of dehydration at temperatures around 60 °C, and repeatability after rehydration. Also positive results were obtained with SrCl 2 and ZnSO 4 with mass differences around 0.02 g/g below 100 °C. Hydroxyethyl Cellulose was chosen as additive to increase the stability and adherence of the coatings. The adsorption properties of the product were evaluated with simultaneous TGA-DTG, while their adherence was characterized by means of a procedure based on the test described in ISO2409. Coatings of CaCl 2 displayed a much improved consistency and adherence, while retaining its adsorption capacity, showing mass differences of around 0.1 g/g at temperatures below 100 °C. Also MgSO 4 retains the capacity of forming hydrates, showing a mass difference of more than 0.04 g/g below 100 °C. Finally, coated metallic fibres were investigated. Results show that the effective heat conductivity of a fibre structure coated with Al 2 (SO 4 ) 3 can be up to 4.7 times higher as compared to a block of pure Al 2 (SO 4 ) 3 . The coverage of the pursued coatings was visually investigated and the internal structure was evaluated by microscopic imaging of cross-sections. Coatings of around 50 µm of Al 2 (SO 4 ) 3 were generated, but in general the process requires optimization to achieve a more uniform distribution., (© 2022. The Author(s).)

Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Paulus, Ohmann, Möhler, Plener and Popow.)

Alleviating the multiple problems of children with autism spectrum disorder (ASD) and its comorbid conditions presents major challenges for the affected children, parents, and therapists. Because of a complex psychopathology, structured therapy and parent training are not always sufficient, especially for those patients with intellectual disability (ID) and multiple comorbidities. Moreover, structured therapy is not available for a large number of patients, and pharmacological support is often needed, especially in those children with additional attention deficit/hyperactivity and oppositional defiant, conduct, and sleep disorders., (© 2021. The Author(s).)

Nonsuicidal self-injury (NSSI) is a major mental health problem associated with negative psychosocial outcomes and it most often starts in early adolescence. Despite this, adolescents are rarely involved in informing the development of interventions designed to address their mental health problems. This study aimed to (1) assess adolescents' needs and preferences about future interventions that are delivered through smartphones and (2) develop a framework with implications for designing engaging digital mental health interventions. Fifteen adolescent girls, aged 12-18 years, who met diagnostic criteria for a current NSSI disorder and were in contact with mental health services, participated in semi-structured interviews. Following a reflexive thematic analysis approach, this study identified two main themes: (1) Experiences of NSSI (depicts the needs of young people related to their everyday experiences of managing NSSI) and (2) App in Context (portrays preferences of young people about smartphone interventions and reflects adolescents' views on how technology itself can improve or hinder engaging with these interventions). Adolescent patients expressed interest in using smartphone mental health interventions if they recognize them as helpful, relevant for their life situation and easy to use. The developed framework suggests that digital mental health interventions are embedded in three contexts (i.e., person using the intervention, mental health condition, and technology-related factors) which together need to inform the development of engaging digital resources. To achieve this, the cooperation among people with lived experience, mental health experts, and human computer interaction professionals is vital.

Background: The treatment of anorexia nervosa (AN) is often challenging due to medical complications as well as high relapse and mortality rates. Studies about effective treatment options for people with AN are particularly scarce in the adolescent population. This paper is a study protocol for a multi-center cohort study assessing the feasibility, acceptability and efficacy of a new, manualized treatment program, the "Maudsley Model of Anorexia Nervosa Treatment for Adolescents and Young Adults" (MANTRa) compared to psychotherapeutic treatment as usual (TAU)., Methods/design: One hundred patients between 13 and 21 years who meet the inclusion criteria will receive 24 to 34 individual weekly MANTRa therapy sessions or weekly TAU sessions. Primary outcome variables will be BMI and eating disorder psychopathology 12 months after baseline. Further changes in central coherence, cognitive flexibility, emotion recognition, comorbid psychopathology (e.g. depression, obsessive-compulsive and anxiety disorders, non-suicidal self-injury), personality factors and therapeutic alliance will be assessed., Discussion: This multi-center study will examine the utility of the treatment program MANTRa for adolescents with AN and, therefore enhances the current knowledge about potential treatments for this patient group., Trial Registration: ClinicalTrials.gov Identifier: NCT03535714 . Registered: 24/05/2018 (retrospectively registered, still recruiting).

Adsorption processes are of great interest in catalysis, material separation, and thermal management. In recent decades, adsorbents have been further investigated because of their applications in adsorption refrigeration, heat pumps, and thermal energy storage. Thus, there is an increasing need to determine the macroscopic properties of the adsorbent, specifically their adsorption/desorption capacity and speed, because these two factors determine the power and size of the corresponding adsorber. Many designs have been proposed, but there is still not a generally adopted technology for the analysis of those properties. In this paper, a novel instrument is described, which is capable of determining the macrokinetic properties of an adsorbent composite, with better control and higher accuracy than gravimetric, volumetric, or barometric installations, and lower price and complexity than spectroscopic installations. The design of the installation is detailed, highlighting the main challenges and critical factors. The two working modes of the installation are described, and one example is provided and analyzed for each of them.

Background: Reducing preoperative anxiety is important as inadequate preoperative management can potentially give rise to behavioral problems in the postoperative course, leading to incalculable quantitative and qualitative handicaps later in life. We compared preanesthetic administration of midazolam to a psychological strategy of walking the children through the operating room and playfully demonstrating anesthesia equipment., Methods: Of 60 children initially randomized, 43 were ultimately evaluated along with their parents. Anxiety was assessed over defined times (T1-T5) using psychometric instruments., Results: Primary outcome parameter: change in mean visual analogue scales (VAS) score before anesthesia (T1) to immediately before its induction (T3) in the pediatric patients. This change was significantly different (P=0.045) with a higher decrease of anxiety in the psychology group (mean - 0.13, 95% confidence interval -2.82 to -0.075) compared to the medication group (mean 1.39, 95% confidence interval 0.12 to 3.01). Secondary outcome parameters, State-Trait Anxiety Inventory (STAI): despite no significant intergroup difference in trait anxiety, state anxiety increased significantly in the medication but not in the psychology group (both true of children and parents). Modified Yale Preoperative Anxiety Scale (m-YPAS): the only significant decreases in parameters (for vocalization and emotional expressivity) were seen in the psychology group, and all parameters confirmed the finding of significantly greater anxiety in the medication group than in the psychology group at T3., Conclusions: All psychometric instruments used in this study indicated that our psychological strategy of preanesthesia preparation was capable of successfully reducing anxiety in paediatric patients and their parents.

Background: Social anxiety disorder (SAD) in adolescents may be associated with the use of maladaptive emotion regulation (ER) strategies. The present study examined the use of maladaptive and adaptive ER strategies in adolescents with SAD., Methods: 30 adolescents with SAD (CLIN) and 36 healthy adolescents for the control group (CON) aged between 11 and 16 years were assessed with the standardized questionnaires PHOKI ( Phobiefragebogen für Kinder und Jugendliche ) for self-reported fears as well as FEEL-KJ ( Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen ) for different emotion regulation strategies., Results: Compared to controls, adolescents with SAD used adaptive ER strategies significantly less often, but made use of maladaptive ER strategies significantly more often. There was a significant positive correlation between maladaptive ER and social anxiety in adolescents. Examining group differences of single ER strategy use, the CLIN and CON differed significantly in the use of the adaptive ER strategy reappraisal with CLIN reporting less use of reappraisal than CON. Group differences regarding the maladaptive ER strategies withdrawal and rumination , as well as the adaptive ER strategy problem - solving were found present, with CLIN reporting more use of withdrawal and rumination and less use of problem - solving than CON., Conclusions: Promoting adaptive emotion regulation should be a central component of psychotherapy (cognitive behavioral therapy-CBT) for social anxiety in adolescents from the beginning of the therapy process. These findings provide rationale for special therapy programs concentrating on the establishment of different adaptive ER strategies (including reappraisal ). As an increased use of maladaptive ER may be associated with SAD in adolescents, it may be paramount to focus on reduction of maladaptive ER (for example withdrawal and rumination ) from the beginning of the psychotherapy process. Incorporating more ER components into psychotherapy (CBT) could increase the treatment efficacy. Further investigations of the patterns of emotion regulation in specific anxiety groups like SAD in adolescents is needed to continue to optimize the psychotherapy (CBT) concept., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)